The recently updated SAMHSA toolkit is designed to offer strategies to health care providers, communities, and local governments for developing practices and policies to help prevent opioid-related overdoses and deaths. Access reports for community members, prescribers, patients and families, and those recovering from opioid overdose.
The MAT Resource Library is supported by the Los Angeles County Health Agency and Department of Public Health, Substance Abuse Prevention and Control. The site provides practical information on Medications for Addiction Treatment (MAT) for providers across health systems (e.g., physical health, mental health, and substance use disorder systems), as well as for patients.
The Improving MAT Project toolkit was developed to improve opioid medication assisted treatment with the largest provider of opioid use disorder treatment in the UK (ChangeGrowLive CGL). They have around 35,000 people on MAT in the community each year.
Annette Dale-Perara, presented on the toolkit at the April 2018 meeting on the International Standards for Drug Use Treatment and shared a couple of contextual issues about this work:
“In England our opioid population is largely an aging heroin using population. Opioid use is stable and going down amongst young people. We think that is because we doubled the numbers in treatment for opioid use disorders from 2002-2006 through additional money and oversight by a then new national body (the National Treatment Agency for Substance Misuse – of NTA – I was Executive Director of Quality). England now has around 257,000 people with opioid use disorders (we had around 252,000 in 2010). We have around 157,000 in opioid substitution treatment in the community a year and around another 20,00 in OST in prison – so in England we have around 69% treatment penetration of those with opioid use disorders.
Some of the key issues we currently face are high levels of poly-substance use amongst our opioid users in treatment (around half use crack and/or cocaine in addition to heroin). We have relatively high levels of opioid use ‘on top’ of OST prescriptions amongst those in treatment – particularly amongst the older cohort. Our research indicates OST is protective against overdose and reduces crime but all opioid use does not stop for around half of those in treatment.
We have relatively opioid overdose rates nationally – mostly amongst those not in treatment and particularly amongst the aging opioid users (about 1,500 a year). We also have a great national data set (NDTMS) and all treatment providers collect and give data to the national database. This includes a validated outcome measurement tool (TOP of the Treatment Outcome Profile). The purpose of the opioid MAT toolkit is to improve the outcomes of those in opioid substitution treatment amongst the CGL population. The work programme is data driven and we are able to give monthly data back to services on their opioid treatment population.
The first improvement goal is and whether each service is improving/reducing the number/% of patients who are using opioids ‘on top’ of prescriptions (a key overdose ask and indicator they may not be getting optimised treatment). There are then other goals to ensure patients achieve stability, reduce overdose risk, build recovery assets etc.”